Shapiro M J
Otolaryngol Head Neck Surg. 1981 Nov-Dec;89(6):969-73. doi: 10.1177/019459988108900618.
In this past few years myocutaneous (MC) flaps have, to a large extent, replaced other flaps. Because of axial blood supply, they may be used without delay. The MC flaps, useful in head and neck reconstruction, are based on the latissimus dorsi, the pectoralis major, the sternomastoid, and the trapezius. All have discrete independent vasculature that acts as a pedicle for the muscle and skin flap. The sternomastoid MC flaps have limited range and only special areas of usefulness. The latissimus dorsi flap, because it requires special positioning of the patient, has not been as popular as the pectoralis major flap, but both have excellent blood supplies and will reach almost any area of the face and neck to fill defects and cover internal or external surfaces. In addition, the pectoralis major MC flap may be able to carry a segment of rib as a bone graft. The trapezius MC flap does not have as great a range as the others and has a long vascular pedicle that must be carefully handled, but it has the distinct advantage of being able to carry viable bone from the scapular spine to the mandible.
在过去几年里，肌皮瓣在很大程度上已取代了其他皮瓣。由于有轴型血供，它们可立即使用。用于头颈部重建的肌皮瓣以背阔肌、胸大肌、胸锁乳突肌和斜方肌为基础。所有这些肌肉都有独立的血管系统，作为肌肉和皮瓣的蒂。胸锁乳突肌肌皮瓣的范围有限，仅在特定区域有用。背阔肌皮瓣由于需要患者特殊体位，不如胸大肌皮瓣受欢迎，但两者血供都很好，几乎能到达面部和颈部的任何区域以填充缺损并覆盖内外部表面。此外，胸大肌肌皮瓣或许能够携带一段肋骨作为骨移植材料。斜方肌肌皮瓣的范围不如其他肌皮瓣大，且有一条必须小心处理的长血管蒂，但它有一个明显优势，即能够将来自肩胛冈的活骨携带至下颌骨。
